骨科虚拟手术系统辅助前交叉韧带重建手术流程的建立  

The Establishment of a Virtual Surgery System-assisted Anterior Cruciate Ligament Reconstruction Surgery Process

作　　者：李松[1] 何飞[1] 杨光[2] 许明卿 华闻达 刘洋[1] 

机构地区：[1]昆明医科大学第一附属医院骨科,云南昆明650032 [2]常州市第四人民医院骨科,江苏常州231000

出　　处：《昆明医科大学学报》2014年第7期78-83,共6页Journal of Kunming Medical University

基　　金：昆明市社会发展科技计划重点资助项目(08S100311);云南省科技计划联合专项基金资助项目(2008C0013R)

摘　　要：目的建立骨科虚拟手术系统辅助前交叉韧带重建术的手术流程,以期提高重建韧带骨隧道定位的准确性.方法利用螺旋CT对1名健康志愿者的双侧膝关节进行扫描,扫描结果以DICOM格式导入自主研发的骨科虚拟手术系统(BioMxsf软件),实现对膝关节三维模型的重建,在重建出的三维模型中对ACL股骨、胫骨止点及骨道出口位置进行确定并标记,结合前交叉韧带重建手术的要求,利用VR和MPR成像技术通过MPR轴位、矢状位和冠状位重建,实现在前交叉韧带重建手术中进行骨道长度、角度的测量及骨道定位,并建立骨科虚拟手术系统辅助前交叉韧带重建手术的标准操作流程,进行手术操作模拟,满足前交叉韧带重建手术术前计划的需要.结果建立了骨科虚拟手术系统辅助前交叉韧带重建手术流程:通过术前CT扫描,获得DICOM格式CT数据,然后将数据导入骨科虚拟手术系统并重建出膝关节三维模型,进行术前膝关节相关参数的测量,最后进行手术模拟.结论骨科虚拟手术系统辅助下前交叉韧带重建术的手术流程的建立,能够帮助医生形成更加直观立体的膝关节形象,并提供准确的骨道长度、角度等数据,使前交叉韧带重建手术的骨道定位更精确、手术方式的选择更合理,从而验证了骨科虚拟手术系统支持下前交叉韧带重建手术的可行性.Objective To improve the accuracy of bone tunnel for reconstruction by establishing a method for anterior cruciate ligament reconstruction surgery process. Methods Spiral CT was used to scan bilateral knee joint of a healthy volunteer, the data was exported as DICOM format, and 3D model of knee joint was reconstructed by self designed software （BioMxs） , and ACL femur, tibia endpoint and exit of bone tunnel were marked. Base on the demand of surgery, axial, sagittal, coronal reconstruction was done through MPR imaging technique, to measure the bone tunnel positioning, length , angles, then the virtual surgery system-assisted surgery process was built to satisfy the demand of anterior crucial ligament reconstruction surgery. Results A virtual surgery system-assisted anterior cruciate ligament reconstruction surgery process was established： perform preoperation CT scan, acquire DICOM data and export to BioMxs for knee 3D reconstruction, measure parameters related to surgery, simulate operation. Conclusion The establishment of the virtual surgery system-assisted anterior cruciate ligament reconstruction surgery process produces more stereoscopic image and provides parameters needed like length and angles for doctors to get more precise lacations, and optimize operation method. This paper confirms the t^asibility of virtual svstem in the anterior crucial ligament reconstruction surgery.

关 键 词：前交叉韧带 虚拟手术系统 三维重建 外科手术 

分 类 号：R684.7[医药卫生—骨科学]